| NPI | 1073826368 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME115624) |
| Additional Taxonomies | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: FL ME115624) |
| 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: FL ME115624) | |
| Enumeration Date | 2010-07-15 |
| Last Update Date | 2015-08-17 |