NPI | 1649397068 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CT 027910) |
Additional Taxonomies | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: CT 027910) |
2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: CT 027910) | |
Enumeration Date | 2007-03-22 |
Last Update Date | 2007-07-08 |