NPI | 1982969325 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: SC 34896) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: SC LL34896) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME166034) | |
Enumeration Date | 2012-07-11 |
Last Update Date | 2024-07-07 |