NPI | 1528323417 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: FL ME128970) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MT202942) |
Enumeration Date | 2012-07-07 |
Last Update Date | 2022-07-21 |