| NPI | 1851350326 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101264177) |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: VA 0101264177) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 200100312) | |
| Enumeration Date | 2006-03-22 |
| Last Update Date | 2022-08-08 |