NPI | 1356458806 |
---|---|
Other Name | LANCE PETER LONGO |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WI 37822) |
Additional Taxonomies | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: MA 74570) |
Enumeration Date | 2006-08-23 |
Last Update Date | 2024-09-18 |