| NPI | 1184060113 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: TN 53871) |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology Addiction Medicine (Licence: TN 53871) |
| 2084B0040X Psychiatry & Neurology Behavioral Neurology & Neuropsychiatry (Licence: TN 53871) | |
| 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: TN 53871) | |
| Enumeration Date | 2013-05-16 |
| Last Update Date | 2024-08-28 |