| NPI | 1679580195 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME0056503) |
| Additional Taxonomies | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: FL ME0056503) |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: FL ME0053503) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: FL ME0056503) | |
| 2084P0805X (Licence: FL ME0056503) | |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2013-01-23 |