| NPI | 1023228327 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: ME MD18024) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: NY 143252) |
| 2084P0802X Psychiatry & Neurology Addiction Psychiatry (Licence: ME MD18024) | |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2016-05-11 |