| NPI | 1255582565 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 244643) |
| Additional Taxonomies | 2084P0015X Psychiatry & Neurology, Psychosomatic Medicine (Licence: MA 244643) |
| 2083A0300X Preventive Medicine, Addiction Medicine (Licence: MA 244643) | |
| 2083A0300X Preventive Medicine, Addiction Medicine (Licence: FL ME139471) | |
| 2084P0015X Psychiatry & Neurology, Psychosomatic Medicine (Licence: FL ME139471) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME139471) | |
| Enumeration Date | 2008-10-06 |
| Last Update Date | 2026-03-29 |