| NPI | 1285630095 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MO 105491) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 105491) |
| 207Q00000X Family Medicine (Licence: AR E-13823) | |
| 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: MO 105491) | |
| 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: AR E-13823) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AR E-13823) | |
| Enumeration Date | 2005-06-27 |
| Last Update Date | 2023-04-17 |