NPI | 1487235818 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX V9840) |
Additional Taxonomies | 208D00000X General Practice (Licence: VA 0101278312) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101278312) | |
Enumeration Date | 2021-04-17 |
Last Update Date | 2025-09-19 |