NPI | 1144540451 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA 20A14158) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX 503OL30907622) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 259107) | |
Enumeration Date | 2010-06-09 |
Last Update Date | 2015-09-24 |