| NPI | 1336249630 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX F2020) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 209098) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CT 023829) | |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: MA 209098) | |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: CT 023829) | |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: TX F2020) | |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2016-08-09 |