NPI | 1609950468 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: FL ME97864) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MN 40860) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME97864) | |
2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: MN 40860) | |
Enumeration Date | 2006-10-25 |
Last Update Date | 2019-09-25 |