NPI | 1821518051 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 287133) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 272193) |
Enumeration Date | 2017-06-20 |
Last Update Date | 2021-06-30 |