NPI | 1487008942 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101283080) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: SC 83428) |
Enumeration Date | 2016-04-20 |
Last Update Date | 2025-08-05 |