| NPI | 1841456209 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: MA 238152) |
| Additional Taxonomies | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: LA MD.205235) |
| 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: FL ME120592) | |
| Enumeration Date | 2008-08-04 |
| Last Update Date | 2014-08-29 |