| NPI | 1699736876 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: VA 0101056674) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101056674) |
| 2084P0805X (Licence: VA 0101056674) | |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2025-09-11 |