| NPI | 1316264435 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: FL ME112401) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME112401) |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: FL ME112401) | |
| Enumeration Date | 2010-04-29 |
| Last Update Date | 2017-10-09 |