NPI | 1487117743 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101286055) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 307754) |
Enumeration Date | 2019-04-12 |
Last Update Date | 2025-08-28 |