| NPI | 1821327420 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: NC 9800516) |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: MD D0043122) |
| 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: PA 038047E) | |
| Enumeration Date | 2009-12-10 |
| Last Update Date | 2022-11-17 |