| NPI | 1801052386 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: CT 51222) |
| Additional Taxonomies | 2084B0002X Psychiatry & Neurology Obesity Medicine (Licence: CT 51222) |
| 2084F0202X Psychiatry & Neurology Forensic Psychiatry (Licence: CT 51222) | |
| 2084P0802X Psychiatry & Neurology Addiction Psychiatry (Licence: CT 51222) | |
| 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: CT 51222) | |
| 2084S0012X Psychiatry & Neurology Sleep Medicine (Licence: CT 51222) | |
| Enumeration Date | 2008-08-04 |
| Last Update Date | 2019-03-05 |