NPI | 1023148772 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: SC 23216) |
Additional Taxonomies | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: SC 23216) |
2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: SC 23216) | |
Enumeration Date | 2007-03-06 |
Last Update Date | 2018-11-15 |