| NPI | 1881870442 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: VA 0101222715) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101222715) |
| 207R00000X Internal Medicine (Licence: VA 0101222715) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101222715) | |
| Enumeration Date | 2008-01-14 |
| Last Update Date | 2020-06-09 |