| NPI | 1124448196 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: ME MD23032) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: ME MD23032) |
| Enumeration Date | 2014-04-17 |
| Last Update Date | 2026-01-30 |