| NPI | 1598907859 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: UT 2429) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: UT 69888) |
| 2083A0300X Preventive Medicine, Addiction Medicine (Licence: UT 61-19140) | |
| Enumeration Date | 2009-04-01 |
| Last Update Date | 2025-02-06 |