| NPI | 1871682047 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 247496) |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: CA a83731) |
| 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: NY 247496) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A83731) | |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2012-06-08 |