NPI | 1639278104 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: HI 5407) |
Additional Taxonomies | 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: HI 5407) |
2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: HI 5407) | |
Enumeration Date | 2006-09-21 |
Last Update Date | 2011-02-01 |