| NPI | 1427670108 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: SC 84132) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: SC LL84132) |
| Enumeration Date | 2020-05-15 |
| Last Update Date | 2024-08-02 |