NPI | 1144858218 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: PA OT023742) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL OS19013) |
Enumeration Date | 2020-04-01 |
Last Update Date | 2024-06-04 |