NPI | 1306929724 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: KY 35215) |
Additional Taxonomies | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: KY 35215) |
2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: KY 35215) | |
Enumeration Date | 2006-10-21 |
Last Update Date | 2008-04-14 |