NPI | 1972765873 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: TN 49443) |
Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: KY C2172) |
Enumeration Date | 2008-07-01 |
Last Update Date | 2025-02-27 |