NPI | 1144686924 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA MD60672211) |
Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: NC 30600) |
Enumeration Date | 2016-01-08 |
Last Update Date | 2016-09-06 |