| NPI | 1821169525 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0802X Psychiatry & Neurology Addiction Psychiatry (Licence: MO R3611) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: MO R3611) |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: MO R3611) | |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2007-07-08 |