| NPI | 1881960417 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: ME MD27335) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VT 042.0013368) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: ME MD27335) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: VT 042.0013368) | |
| Enumeration Date | 2012-03-28 |
| Last Update Date | 2023-09-28 |