| NPI | 1811983596 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AL 00026085) |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: AL 26085) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TN MD0000057182) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GA 77238) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME10550) | |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: AL 26085) | |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: GA 77238) | |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: FL ME10550) | |
| Enumeration Date | 2005-09-27 |
| Last Update Date | 2023-06-01 |