| NPI | 1932350691 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AK 140668) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 262855-1) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: ME MD19178) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME118056) | |
| Enumeration Date | 2008-09-30 |
| Last Update Date | 2019-07-19 |