NPI | 1558725010 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: IA MD-50177) |
Additional Taxonomies | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: MA 279750) |
2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: IA MD-50177) | |
Enumeration Date | 2016-04-11 |
Last Update Date | 2024-03-19 |