| NPI | 1134157381 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: GA 031577) |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: SC 14205) |
| 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: FL ME0066626) | |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2015-05-29 |