| NPI | 1134431927 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: GA 080038) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: IN 01072373A) |
| 2084P0802X Psychiatry & Neurology Addiction Psychiatry (Licence: CA A139521) | |
| Enumeration Date | 2010-07-08 |
| Last Update Date | 2024-08-07 |