NPI | 1124007380 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MO 2004022302) |
Additional Taxonomies | 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: MO 2004022302) |
Enumeration Date | 2006-01-15 |
Last Update Date | 2023-03-07 |