| NPI | 1164470449 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: FL ME82196) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL me82196) |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2013-07-26 |