| NPI | 1770823148 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TN 61005) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 279037) |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: TN 61005) | |
| Enumeration Date | 2013-02-22 |
| Last Update Date | 2024-10-29 |