| NPI | 1710208970 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA C167347) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: SC ll32812) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: SC 32812) | |
| 2083A0300X Preventive Medicine, Addiction Medicine (Licence: CA C167347) | |
| Enumeration Date | 2010-06-22 |
| Last Update Date | 2024-04-30 |