| NPI | 1154862886 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: HI MD-20405) |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: CT 67362) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CT 67362) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: HI MD-20405) | |
| Enumeration Date | 2017-03-14 |
| Last Update Date | 2024-12-05 |