| NPI | 1598532483 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0024188927) |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: VA 0024188927) |
| Enumeration Date | 2023-12-11 |
| Last Update Date | 2023-12-12 |