NPI | 1174573869 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD048252L) |
Additional Taxonomies | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: PA MD048252L) |
Enumeration Date | 2006-05-11 |
Last Update Date | 2007-08-08 |