NPI | 1457490443 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CO DR.0064885) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 00000000) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NM 2005-0340) | |
Enumeration Date | 2007-02-06 |
Last Update Date | 2020-08-24 |