NPI | 1467911701 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 279937) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 279937) |
Enumeration Date | 2019-03-17 |
Last Update Date | 2019-07-04 |