NPI | 1578746384 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MS 21311) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: LA 201004) |
Enumeration Date | 2007-12-14 |
Last Update Date | 2024-06-27 |