| NPI | 1952377319 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NM 2002-0014) |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: NM 2002-0014) |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2018-01-30 |