| NPI | 1932195823 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME85148) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME85148) |
| 208D00000X General Practice (Licence: FL ME85148) | |
| Enumeration Date | 2005-09-26 |
| Last Update Date | 2024-01-26 |