| NPI | 1275575870 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: NV 10116) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: KY 35565) |
| 2084P0802X Psychiatry & Neurology Addiction Psychiatry (Licence: AK 3148) | |
| 2084P0802X Psychiatry & Neurology Addiction Psychiatry (Licence: IN 01055808A) | |
| 2084P0805X Psychiatry & Neurology Geriatric Psychiatry (Licence: TN XS6928886) | |
| Enumeration Date | 2006-06-11 |
| Last Update Date | 2012-06-21 |