| NPI | 1760567879 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PR 8282) |
| Additional Taxonomies | 2084P0805X (Licence: PR 8282) |
| 2084S0012X Psychiatry & Neurology, Sleep Medicine (Licence: PR 8282) | |
| 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: PR 8282) | |
| 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: PR 8282) | |
| 2084P0015X Psychiatry & Neurology, Psychosomatic Medicine (Licence: PR 8282) | |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: PR 8282) | |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: PR 8282) | |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2012-03-01 |