NPI | 1093919672 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: KY 03648) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: TX M5890) |
Enumeration Date | 2007-06-14 |
Last Update Date | 2024-06-10 |