NPI | 1992812762 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI 4301108828) |
Additional Taxonomies | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: AK 6615) |
2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: FL ME 86346) | |
Enumeration Date | 2006-08-25 |
Last Update Date | 2024-01-23 |