NPI | 1578721221 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GA 078825) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WV 390200000x) |
Enumeration Date | 2008-05-29 |
Last Update Date | 2022-01-06 |