NPI | 1003903154 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX R6184) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CO 43400) |
Enumeration Date | 2006-10-09 |
Last Update Date | 2018-05-15 |