NPI | 1316979693 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MN 50572) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA md064850l) |
Enumeration Date | 2006-07-07 |
Last Update Date | 2020-08-20 |