| NPI | 1174824726 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A146644) |
| Additional Taxonomies | 2084P0015X Psychiatry & Neurology, Psychosomatic Medicine (Licence: CA A146644) |
| 2084P0015X Psychiatry & Neurology, Psychosomatic Medicine (Licence: TX S3670) | |
| 2084P0015X Psychiatry & Neurology, Psychosomatic Medicine (Licence: CO DR.0062123) | |
| 2084P0015X Psychiatry & Neurology, Psychosomatic Medicine (Licence: PA MD465601) | |
| 2084P0015X Psychiatry & Neurology, Psychosomatic Medicine (Licence: FL ME143769) | |
| 2084P0015X Psychiatry & Neurology, Psychosomatic Medicine (Licence: AK 132925) | |
| 261QM0850X Clinic/Center, Adult Mental Health (Licence: TX S3670) | |
| 261QM0850X Clinic/Center, Adult Mental Health (Licence: NC 2019-01766) | |
| 261QM0850X Clinic/Center, Adult Mental Health (Licence: NY 292908) | |
| 261QM0850X Clinic/Center, Adult Mental Health (Licence: CO DR.0062123) | |
| 261QM0850X Clinic/Center, Adult Mental Health (Licence: FL ME143769) | |
| 261QM0850X Clinic/Center, Adult Mental Health (Licence: PA MD465601) | |
| Enumeration Date | 2010-11-14 |
| Last Update Date | 2023-07-30 |