| NPI | 1417190661 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: NH 19180) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NH 19180) |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: NY 258530) | |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: CA A142053) | |
| Enumeration Date | 2009-04-16 |
| Last Update Date | 2018-11-14 |