NPI | 1487709200 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WI 39227) |
Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: WI 39227) |
2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: WI 39227) | |
Enumeration Date | 2007-01-24 |
Last Update Date | 2021-12-03 |