| NPI | 1821350398 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD453149) |
| Additional Taxonomies | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: PA MD453149) |
| Enumeration Date | 2012-06-11 |
| Last Update Date | 2021-08-03 |