NPI | 1710484274 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI 4301505495) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI 4301114494) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI 4351029091) | |
Enumeration Date | 2018-04-11 |
Last Update Date | 2023-11-02 |