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 |