NPI | 1629169412 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI 4301040933) |
Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: MI 040933) |
Enumeration Date | 2006-09-27 |
Last Update Date | 2023-08-16 |