| NPI | 1356394050 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 31639) |
| Additional Taxonomies | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: NC 31639) |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: NC 31639) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: NC 31639) | |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: NC 31639) | |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2014-02-15 |