NPI | 1619598091 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME169694) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GA 100574) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0116034614) | |
Enumeration Date | 2020-04-27 |
Last Update Date | 2024-11-15 |