NPI | 1770573107 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: WA MD00045782) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: IN 01054302A) |
Enumeration Date | 2005-10-26 |
Last Update Date | 2021-03-30 |