| NPI | 1841330552 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME31300) |
| Additional Taxonomies | 2084P0805X (Licence: FL ME 31300) |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2009-09-15 |