NPI | 1487648143 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: IA 23610) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IA 23610) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 20601) | |
Enumeration Date | 2005-09-08 |
Last Update Date | 2007-07-08 |