| NPI | 1740975804 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME177775) |
| Additional Taxonomies | 2084P0805X (Licence: FL ME177775) |
| Enumeration Date | 2023-04-05 |
| Last Update Date | 2026-01-12 |