| NPI | 1841274594 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 278301) |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: MA 278301) |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: MA 278301) | |
| Enumeration Date | 2005-12-05 |
| Last Update Date | 2023-06-08 |