| NPI | 1184859365 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME48178) |
| Additional Taxonomies | 173000000X Legal Medicine (Licence: FL ME0048178) |
| Enumeration Date | 2009-05-18 |
| Last Update Date | 2011-07-01 |