NPI | 1225777311 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: ND RL18551) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: ND 21334) |
Enumeration Date | 2022-05-27 |
Last Update Date | 2024-08-08 |