NPI | 1578779898 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: GA 064414) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: MI 4301094470) |
2084P0800X Psychiatry & Neurology Psychiatry (Licence: PA MT185687) | |
Enumeration Date | 2007-05-15 |
Last Update Date | 2020-08-05 |