| NPI | 1942434311 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 245830) |
| Additional Taxonomies | 2083C0008X Preventive Medicine, Clinical Informatics Specialist (Licence: MA 245830) |
| 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: MA 245830) | |
| Enumeration Date | 2009-05-13 |
| Last Update Date | 2023-01-09 |