| NPI | 1932156056 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: VA 0101053286) |
| Additional Taxonomies | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: NC 33063) |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2012-09-11 |