NPI | 1700148871 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AZ R73300) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OR MD223090) |
Enumeration Date | 2012-06-13 |
Last Update Date | 2025-07-11 |