NPI | 1982695284 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0015X Psychiatry & Neurology, Psychosomatic Medicine (Licence: MA 216680) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 216680) |
2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: MA 216680) | |
Enumeration Date | 2005-11-04 |
Last Update Date | 2011-03-29 |