| NPI | 1427116706 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AZ 11421) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME 82102) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD-073143-L) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA G86252) | |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: AZ 11421) | |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: FL ME 82102) | |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: PA MD-073132) | |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: CA G86252) | |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2023-03-07 |