| NPI | 1952308181 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 2084F0202X Psychiatry & Neurology Forensic Psychiatry (Licence: FL ME 71703) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: FL ME 71703) |
| Enumeration Date | 2005-07-01 |
| Last Update Date | 2007-07-08 |