NPI | 1902092695 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MO 2021007075) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A130470) |
Enumeration Date | 2007-09-17 |
Last Update Date | 2021-04-09 |