| NPI | 1396833620 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: SC 0341) |
| Additional Taxonomies | 2084P0301X Psychiatry & Neurology, Brain Injury Medicine (Licence: GA 042687) |
| 2084P0301X Psychiatry & Neurology, Brain Injury Medicine (Licence: SC 0341) | |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: OH 4723) | |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: GA 042687) | |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: PA OS-005919-L) | |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: NC 75297) | |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2023-08-22 |