NPI | 1174534036 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: KY 32360) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NH LT3548) |
Enumeration Date | 2006-08-10 |
Last Update Date | 2016-05-16 |