NPI | 1154612885 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A122818) |
Additional Taxonomies | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: CA A122818) |
Enumeration Date | 2011-04-28 |
Last Update Date | 2023-08-15 |