NPI | 1063511392 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: FL ME135495) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: PR 15359) |
Enumeration Date | 2006-09-22 |
Last Update Date | 2024-03-27 |