NPI | 1851381776 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AZ 37644) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MN 39978) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME80405) | |
Enumeration Date | 2005-10-22 |
Last Update Date | 2020-08-03 |