| NPI | 1891012233 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084A0401X Psychiatry & Neurology Addiction Medicine (Licence: WV 2738) |
| Additional Taxonomies | 2084P0802X Psychiatry & Neurology Addiction Psychiatry (Licence: WV 2738) |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: WV 2738) | |
| Enumeration Date | 2010-04-26 |
| Last Update Date | 2014-12-18 |