| NPI | 1821145798 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TN 53908) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: KY 43435) |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: KY 43435) | |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: TN 53908) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: KY 43435) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: TN 53908) | |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2022-07-21 |