| NPI | 1821382730 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101283659) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME116830) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL TRN15977) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: ME MD28377) | |
| Enumeration Date | 2011-06-08 |
| Last Update Date | 2025-07-11 |