NPI | 1205867637 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A22153) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CO 23169) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: ME 011844) | |
Enumeration Date | 2006-07-05 |
Last Update Date | 2025-09-11 |