NPI | 1467606616 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA MD61573411) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WI 57260-20) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME155724) | |
Enumeration Date | 2008-11-13 |
Last Update Date | 2024-08-08 |