| NPI | 1093916868 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME97612)  | 
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: FL ME97612)  | 
| Enumeration Date | 2007-05-30 | 
| Last Update Date | 2025-02-19 |