| NPI | 1508091281 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: ME MD20613)  | 
| Additional Taxonomies | 202C00000X Independent Medical Examiner (Licence: ME MD20613)  | 
| 2083A0300X Preventive Medicine, Addiction Medicine (Licence: ME MD20613)  | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: ME MD20613)  | |
| Enumeration Date | 2009-05-25 | 
| Last Update Date | 2025-08-22 |