NPI | 1851578579 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: KY 44445) |
Additional Taxonomies | 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: KY 44445) |
Enumeration Date | 2008-01-24 |
Last Update Date | 2023-11-14 |