NPI | 1720081987 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: FL ME90437) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: PA MD424452) |
2084P0800X Psychiatry & Neurology Psychiatry (Licence: SC 52255) | |
2084P0800X Psychiatry & Neurology Psychiatry (Licence: NY 214959) | |
Enumeration Date | 2005-05-23 |
Last Update Date | 2022-10-10 |