NPI | 1972583706 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VT 420009703) |
Additional Taxonomies | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: VT 420009703) |
2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: VT 420009703) | |
Enumeration Date | 2006-01-18 |
Last Update Date | 2007-07-08 |