NPI | 1417001462 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD D0017860) |
Additional Taxonomies | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: MD D0017860) |
Enumeration Date | 2007-01-23 |
Last Update Date | 2016-03-22 |