NPI | 1679553853 |
---|---|
Other Name | MICHAEL JUDE COLSTON |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: VA 0101102701) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101102701) |
Enumeration Date | 2006-01-22 |
Last Update Date | 2020-11-03 |