NPI | 1194881888 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA G23317) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: CA G23317) |
Enumeration Date | 2006-12-28 |
Last Update Date | 2023-03-07 |