NPI | 1134235062 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA MD60335230) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AZ 34350) |
Enumeration Date | 2006-08-22 |
Last Update Date | 2020-09-10 |