NPI | 1073774238 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MO 2011019835) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: KS 04-39077) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GA 94029) | |
Enumeration Date | 2008-06-20 |
Last Update Date | 2024-07-19 |