NPI | 1073764577 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101279226) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IN 01070541A) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME142635) | |
Enumeration Date | 2008-10-02 |
Last Update Date | 2024-04-19 |