| NPI | 1801578752 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TP0016X Psychologist Prescribing (Medical) |
| Additional Taxonomies | 2084P0802X Psychiatry & Neurology Addiction Psychiatry (Licence: NV J5M6H2Q9) |
| Enumeration Date | 2023-08-01 |
| Last Update Date | 2023-08-01 |