NPI | 1013570811 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX T2384) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CO DR.0071529) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 324874) | |
Enumeration Date | 2019-04-17 |
Last Update Date | 2023-07-10 |