NPI | 1649267188 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101035045) |
Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: VA 0101035045) |
2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: VA 0101035045) | |
Enumeration Date | 2005-09-30 |
Last Update Date | 2022-05-25 |