NPI | 1174850697 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AZ 47614) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 35.099235) |
Enumeration Date | 2009-11-04 |
Last Update Date | 2019-07-16 |