| NPI | 1841283199 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TN MD31821) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN MD31821) |
| 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: MI 5315215826) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WV 29546) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MT MED-PHYS-LIC-81169) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WI 678) | |
| Enumeration Date | 2005-08-23 |
| Last Update Date | 2023-03-10 |