| NPI | 1871519041 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NV 20009) |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: NV 20009) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036-132238) | |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2020-10-09 |