| NPI | 1992956601 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: MD d45444) |
| Additional Taxonomies | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: DC MD 036634) |
| Enumeration Date | 2008-10-01 |
| Last Update Date | 2008-10-01 |