NPI | 1023508587 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX S4161) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX BP10063889) |
Enumeration Date | 2018-05-10 |
Last Update Date | 2025-06-03 |