NPI | 1306058540 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL 92785) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CT 30145) |
Enumeration Date | 2007-05-03 |
Last Update Date | 2025-09-15 |