| NPI | 1932172020 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PR 16243) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME0097479) |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: FL ME0097479) | |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: PR 16243) | |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: PR 16243) | |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: FL ME0097479) | |
| Enumeration Date | 2006-02-09 |
| Last Update Date | 2020-09-01 |