| NPI | 1689662181 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME49249) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: FL ME492249) |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: FL ME492249) | |
| Enumeration Date | 2005-10-10 |
| Last Update Date | 2024-01-15 |