| NPI | 1770511156 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GA 37324) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GA 037324) |
| 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: GA 37324) | |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: GA 37324) | |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2021-04-22 |