NPI | 1023151537 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AZ 4098) |
Additional Taxonomies | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: AZ 4098) |
2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: CA 20A10101) | |
2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: AZ 4098) | |
Enumeration Date | 2007-02-14 |
Last Update Date | 2020-10-07 |