NPI | 1013302108 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OR DO187942) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: SC 83703) |
Enumeration Date | 2015-04-06 |
Last Update Date | 2022-02-22 |