NPI | 1174676274 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 295363) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD456309) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD D0059516) | |
Enumeration Date | 2007-01-19 |
Last Update Date | 2023-01-31 |