| NPI | 1437647468 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: PA MD475877) |
| Additional Taxonomies | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: PA MD475877) |
| 2083A0300X Preventive Medicine, Addiction Medicine (Licence: PA MD475877) | |
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: PA MD475877) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-04-25 |
| Last Update Date | 2025-09-11 |