| NPI | 1477649168 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NH 13557) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 266779) |
| 207R00000X Internal Medicine (Licence: NH RT1513) | |
| 2083A0300X Preventive Medicine, Addiction Medicine (Licence: NH 13557) | |
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: NH 13557) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 2019-02131) | |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2022-08-11 |