| NPI | 1316033350 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: VA 0101244180) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 212008) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101244180) | |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2020-07-23 |