NPI | 1134211568 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: ND 7777) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: ND 7777) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: ND 7777) | |
Enumeration Date | 2006-09-30 |
Last Update Date | 2023-06-15 |