| NPI | 1649284688 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: CA 20186) |
| Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: IN 02001636) |
| 2084B0040X Psychiatry & Neurology Behavioral Neurology & Neuropsychiatry (Licence: MI 5101011298) | |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: MO 200400631) | |
| 2084P0802X Psychiatry & Neurology Addiction Psychiatry (Licence: MO 2004001631) | |
| 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: IN 02001636) | |
| 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: MO 2004001631) | |
| 208D00000X General Practice (Licence: IN 02001636) | |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2022-12-23 |