NPI | 1619498557 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0805X Psychiatry & Neurology Geriatric Psychiatry (Licence: MO 2020031778) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: MO 2020031778) |
2084P0800X Psychiatry & Neurology Psychiatry (Licence: HI MD22897) | |
Enumeration Date | 2017-06-30 |
Last Update Date | 2024-08-21 |