NPI | 1285257113 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD478772) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2024034697) |
Enumeration Date | 2020-05-27 |
Last Update Date | 2024-09-12 |