| NPI | 1194040576 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: ID O-1733) |
| Additional Taxonomies | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: ID O-1733) |
| 2083A0300X Preventive Medicine, Addiction Medicine (Licence: WA OP60447877) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA OP60447877) | |
| Enumeration Date | 2010-03-29 |
| Last Update Date | 2022-09-30 |