| NPI | 1831329655 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084H0002X (Licence: FL ME143143) |
| Additional Taxonomies | 2084H0002X (Licence: VA 0101257173) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: FL ME143143) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101257173) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME143143) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: VA 0101257173) | |
| Enumeration Date | 2009-07-15 |
| Last Update Date | 2020-03-18 |