NPI | 1386617421 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA C158794) |
Additional Taxonomies | 174400000X Specialist (Licence: PA MD425314) |
Enumeration Date | 2006-02-09 |
Last Update Date | 2023-05-31 |