| NPI | 1568449916 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OR MD203430) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD073837L) |
| 207P00000X Emergency Medicine (Licence: CA C140172) | |
| 207P00000X Emergency Medicine (Licence: MI 4301115779) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 4301115779) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI 4301115779) | |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: MI 4301115779) | |
| Enumeration Date | 2005-12-28 |
| Last Update Date | 2022-05-24 |