NPI | 1215192174 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX Q2758) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI 4301092268) |
Enumeration Date | 2008-07-21 |
Last Update Date | 2021-06-06 |