| NPI | 1598714131 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 6758593) |
| Additional Taxonomies | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: NC 15665) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 15665) | |
| 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: NC 15665) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: NC 15665) | |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2010-07-06 |