NPI | 1861470213 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: MA 57151) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY S235135-1) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA G71698) | |
Enumeration Date | 2006-01-05 |
Last Update Date | 2012-11-14 |