| NPI | 1588732432 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME121035) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: ME EC-06-1090) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: WV 24529) | |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2015-09-09 |