NPI | 1477563203 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OR MD18191) |
Additional Taxonomies | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: OR MD18191) |
2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: OR MD18191) | |
Enumeration Date | 2006-08-08 |
Last Update Date | 2011-09-20 |