NPI | 1689198350 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD D0093357) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: DC MD210001976) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 305497) | |
Enumeration Date | 2017-08-03 |
Last Update Date | 2024-02-06 |