| NPI | 1992834311 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME144972) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IN 01078902A) |
| 174400000X Specialist (Licence: FL ME144972) | |
| Enumeration Date | 2007-03-02 |
| Last Update Date | 2023-01-11 |