| NPI | 1629089677 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: FL ME137499) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: FL ME137499) |
| 2084P0802X Psychiatry & Neurology Addiction Psychiatry (Licence: FL ME137499) | |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2020-09-17 |