NPI | 1356338784 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME122053) |
Additional Taxonomies | 174400000X Specialist (Licence: NH 9668) |
Enumeration Date | 2005-09-30 |
Last Update Date | 2015-03-20 |