NPI | 1760455133 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 2014-02539) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2014-02539) |
2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 2014-02539) | |
Enumeration Date | 2006-02-08 |
Last Update Date | 2024-07-15 |