| NPI | 1518122886 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: VA 0101272840) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI 4301090538) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GA 90224) | |
| Enumeration Date | 2008-07-25 |
| Last Update Date | 2024-06-03 |