NPI | 1811195126 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AZ 59732) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA C55780) |
Enumeration Date | 2007-07-08 |
Last Update Date | 2023-07-19 |