NPI | 1871988584 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A162067) |
Additional Taxonomies | 2084P0015X Psychiatry & Neurology, Psychosomatic Medicine (Licence: NY 304804) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 304804) | |
Enumeration Date | 2015-03-31 |
Last Update Date | 2024-04-23 |