NPI | 1710918206 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA G137265) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX N8347) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 151833) | |
Enumeration Date | 2006-07-05 |
Last Update Date | 2021-12-07 |