NPI | 1295094316 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OR MD193287) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NV 17077) |
Enumeration Date | 2012-05-09 |
Last Update Date | 2021-08-04 |