NPI | 1811130917 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX R1749) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WI 2979-320) |
Enumeration Date | 2009-04-20 |
Last Update Date | 2025-05-02 |