| NPI | 1356576854 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: NM MD2009-0726) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NM MD2009-0726) |
| Enumeration Date | 2009-05-28 |
| Last Update Date | 2025-01-03 |