NPI | 1043659121 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD467692) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MT202664) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 284982) | |
Enumeration Date | 2013-06-21 |
Last Update Date | 2021-02-18 |