| NPI | 1831553528 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI 5101022446) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MI 5315076014) |
| 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: MI 5101022446) | |
| Enumeration Date | 2016-04-08 |
| Last Update Date | 2023-03-06 |