NPI | 1750011698 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OK 41428) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2021045674) |
Enumeration Date | 2022-06-14 |
Last Update Date | 2024-06-19 |