| NPI | 1285969659 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: HI MD-21638) |
| Additional Taxonomies | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: HI 61-20399) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VT 042-0012732) | |
| Enumeration Date | 2009-10-02 |
| Last Update Date | 2024-09-19 |