NPI | 1285029934 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: SD 11600) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MN 64309) |
Enumeration Date | 2015-03-31 |
Last Update Date | 2025-05-16 |