NPI | 1962452862 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101055932) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: SC 89656) |
Enumeration Date | 2006-05-11 |
Last Update Date | 2024-01-08 |