NPI | 1730298902 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MO R3H18) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: KY 32007) |
Enumeration Date | 2006-08-30 |
Last Update Date | 2021-04-01 |