NPI | 1679646467 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 265107) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NH 8509) |
Enumeration Date | 2006-11-17 |
Last Update Date | 2023-01-26 |