NPI | 1124069372 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI 4301113766) |
Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: MI 4301113766) |
2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: MA 150175) | |
2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: MI 4301113766) | |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 150175) | |
Enumeration Date | 2006-06-09 |
Last Update Date | 2022-07-21 |