| NPI | 1548373525 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: NC 2010-00195) |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology Addiction Medicine (Licence: NC 2010-00195) |
| 2084B0040X Psychiatry & Neurology Behavioral Neurology & Neuropsychiatry (Licence: NC 2010-00195) | |
| 2084P2900X Psychiatry & Neurology Pain Medicine (Licence: NC 2010-00195) | |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2014-04-11 |