| NPI | 1437538931 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IA MD-47616) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA R10270) |
| 207R00000X Internal Medicine (Licence: IA MD-47616) | |
| 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: IA MD-47616) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IA R10270) | |
| Enumeration Date | 2015-05-29 |
| Last Update Date | 2021-07-28 |