NPI | 1629336730 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IA MD-42607) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WI 64239-20) |
Enumeration Date | 2012-04-26 |
Last Update Date | 2024-11-20 |