| NPI | 1700270873 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NM MD2019-0803) |
| Additional Taxonomies | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: NM MD2019-0803) |
| 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: NM MD2019-0803) | |
| Enumeration Date | 2015-03-26 |
| Last Update Date | 2024-05-31 |