| NPI | 1932160561 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME100591) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: SC 13256) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: SC 13256) | |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2009-07-28 |