| NPI | 1497756670 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: NM 85-176) |
| Additional Taxonomies | 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: NM 85-176) |
| 2084P0005X Psychiatry & Neurology, Neurodevelopmental Disabilities (Licence: NM 85-176) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NM 85-176) | |
| 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: NM 85-176) | |
| Enumeration Date | 2005-08-10 |
| Last Update Date | 2007-07-08 |