NPI | 1508955071 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: GA 012470) |
Additional Taxonomies | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: GA 12470) |
Enumeration Date | 2006-10-12 |
Last Update Date | 2015-09-08 |