| NPI | 1285175075 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: WA OP61268604) |
| Additional Taxonomies | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: CA 20A18699) |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: HI DOS1929) | |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: NY 312778) | |
| Enumeration Date | 2017-03-14 |
| Last Update Date | 2025-12-15 |