NPI | 1811336126 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: SC 35988) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC LL35988) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: SC LL35988) | |
Enumeration Date | 2013-06-19 |
Last Update Date | 2021-06-07 |