NPI | 1669918462 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD471426) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: DE C7-0006398) |
Enumeration Date | 2017-01-17 |
Last Update Date | 2022-01-07 |