NPI | 1205451085 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OR MD221951) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: KS 94-10378) |
Enumeration Date | 2020-06-08 |
Last Update Date | 2025-03-24 |