| NPI | 1346386299 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: PA OS03158L) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA OS-003158-L) |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: PA OS-003158-L) | |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2012-01-17 |