NPI | 1467853705 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WI 81438) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI 5101025943) |
Enumeration Date | 2014-09-05 |
Last Update Date | 2024-03-25 |