NPI | 1073539862 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: LA 201769) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OR MD25607) |
Enumeration Date | 2006-07-14 |
Last Update Date | 2025-09-23 |