NPI | 1588676365 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0802X Psychiatry & Neurology Addiction Psychiatry (Licence: DE C10004287) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: DE C10004287) |
Enumeration Date | 2006-08-12 |
Last Update Date | 2007-07-08 |