NPI | 1164804282 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX S2395) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: SC LL38498) |
Enumeration Date | 2015-06-25 |
Last Update Date | 2025-02-19 |