| NPI | 1629091335 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: ME MD14897) |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: ME MD14897) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2024-02-14 |