NPI | 1588027403 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CT 66461) |
Additional Taxonomies | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: TX V5850) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GA 94706) | |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX V5850) | |
2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: CT 66461) | |
2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: GA 94706) | |
Enumeration Date | 2016-03-29 |
Last Update Date | 2025-03-05 |