NPI | 1114029766 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NH RT 1201) |
Additional Taxonomies | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: NH RT 1201) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VT 0420011417) | |
Enumeration Date | 2006-09-03 |
Last Update Date | 2013-03-26 |