| NPI | 1801349410 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: MT 117179) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A148598) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX s1890) | |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: TX S1890) | |
| Enumeration Date | 2016-07-31 |
| Last Update Date | 2022-10-27 |