NPI | 1851733711 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101268074) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX R2385) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MO 2019047208) | |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX FK6822200) | |
Enumeration Date | 2013-07-20 |
Last Update Date | 2020-06-09 |