| NPI | 1841419058 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084A0401X Psychiatry & Neurology Addiction Medicine (Licence: FL OS15367) |
| Additional Taxonomies | 208D00000X General Practice (Licence: WV 832) |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2018-08-24 |