NPI | 1558681429 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: MO 67679) |
Additional Taxonomies | 2084P0805X Psychiatry & Neurology Geriatric Psychiatry (Licence: TX 3339) |
Enumeration Date | 2010-06-02 |
Last Update Date | 2021-11-30 |