NPI | 1205181724 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: ND 14085) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX S1672) |
Enumeration Date | 2012-07-20 |
Last Update Date | 2025-01-07 |