| NPI | 1235497165 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: CA 127717) |
| Additional Taxonomies | 2083A0300X Preventive Medicine Addiction Medicine (Licence: CA 127717) |
| 2083C0008X Preventive Medicine Clinical Informatics (Licence: CA 127717) | |
| Enumeration Date | 2012-04-28 |
| Last Update Date | 2021-12-13 |