NPI | 1811148380 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: KY 52153) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IA 44855) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WI 55305-20) | |
Enumeration Date | 2008-10-02 |
Last Update Date | 2019-02-04 |