| NPI | 1073779799 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TN 45653) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101246145) |
| 2083A0300X Preventive Medicine, Addiction Medicine (Licence: TN 45653) | |
| 2083A0300X Preventive Medicine, Addiction Medicine (Licence: VA 0101246145) | |
| Enumeration Date | 2008-08-01 |
| Last Update Date | 2025-09-17 |