NPI | 1740861814 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA 61645439) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CO 0071791) |
Enumeration Date | 2021-04-19 |
Last Update Date | 2025-05-02 |