NPI | 1033244660 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A98748) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A98748) |
Enumeration Date | 2007-02-23 |
Last Update Date | 2021-10-16 |