NPI | 1215913116 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: HI 12961) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: HI 12961) |
Enumeration Date | 2005-12-22 |
Last Update Date | 2025-09-11 |