NPI | 1255372058 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI 4301049890) |
Additional Taxonomies | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: MI 4301049890) |
2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: MI 4301049890) | |
Enumeration Date | 2006-06-10 |
Last Update Date | 2015-11-04 |