NPI | 1558620278 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 010125819) |
Additional Taxonomies | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: VA 0101258192) |
2083A0300X Preventive Medicine, Addiction Medicine (Licence: TN 54778) | |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TN 54778) | |
Enumeration Date | 2012-05-15 |
Last Update Date | 2025-08-19 |