NPI | 1538269683 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: LA 021216) |
Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: LA 021216) |
Enumeration Date | 2006-09-25 |
Last Update Date | 2019-09-04 |