| NPI | 1982846028 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: FL ME103702) |
| Additional Taxonomies | 208800000X Urology (Licence: FL ME103702) |
| Enumeration Date | 2009-04-06 |
| Last Update Date | 2013-04-02 |