NPI | 1124122114 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: TN 33785) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: VA 0101238440) |
Enumeration Date | 2006-09-11 |
Last Update Date | 2007-07-08 |