NPI | 1972596773 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD D18703) |
Additional Taxonomies | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: MD D18703) |
Enumeration Date | 2005-08-26 |
Last Update Date | 2021-08-25 |