NPI | 1306136957 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CT 61719) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 61719) |
Enumeration Date | 2011-04-17 |
Last Update Date | 2024-12-25 |