NPI | 1780664524 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD042255L) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME143545) |
Enumeration Date | 2006-01-18 |
Last Update Date | 2024-01-02 |