| NPI | 1083068209 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: GA 99760) |
| Additional Taxonomies | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: DC MD210012177) |
| Enumeration Date | 2016-04-14 |
| Last Update Date | 2025-03-18 |