| NPI | 1023284353 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: NC 2016-02570) |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: FL ME86759) |
| Enumeration Date | 2008-05-06 |
| Last Update Date | 2017-05-09 |