| NPI | 1568496560 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TN 45914) |
| Additional Taxonomies | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: TN 45914) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2022-11-05 |