NPI | 1356340855 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WY 2361A) |
Additional Taxonomies | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: WY 2361A) |
2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: WY 2361A) | |
Enumeration Date | 2005-07-18 |
Last Update Date | 2011-03-14 |