| NPI | 1801986856 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WI 28073-020) |
| Additional Taxonomies | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: WI 28073-020) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2021-04-09 |