| NPI | 1093789083 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 72605) |
| Additional Taxonomies | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: MA 72605) |
| 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: MA 72605) | |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2013-05-03 |