| NPI | 1265507628 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME53120) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: SC 19584SC) |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: IN 01029010C) | |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2014-06-05 |