| NPI | 1407934912 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: FL ME78898) |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: FL ME78898) |
| 2084P0015X Psychiatry & Neurology, Psychosomatic Medicine (Licence: FL ME78898) | |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2021-01-07 |