NPI | 1457434870 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: KY 35167) |
Additional Taxonomies | 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: KY 35167) |
Enumeration Date | 2006-10-21 |
Last Update Date | 2019-06-14 |