| NPI | 1467683300 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: TN 50538) |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: PA MD479400) |
| 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: VA 0101250414) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TN 50538) | |
| 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: TN 50538) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101250414) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD479400) | |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: VA 0101250414) | |
| Enumeration Date | 2009-07-27 |
| Last Update Date | 2025-08-21 |