| NPI | 1528078466 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: TX J4423) |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: TX J4423) |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2014-04-11 |