NPI | 1679623375 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TN MD0000003897) |
Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: TN MD0000003897) |
Enumeration Date | 2007-01-12 |
Last Update Date | 2018-07-03 |