| NPI | 1437195534 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: FL ME54131) |
| Additional Taxonomies | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: AL 00024147) |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: LA MD07713R) | |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2012-04-17 |