NPI | 1508151762 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: ID M-15337) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CT 69537) |
Enumeration Date | 2011-06-16 |
Last Update Date | 2025-09-15 |