NPI | 1205974490 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA MD00023198) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA G72267) |
Enumeration Date | 2007-02-01 |
Last Update Date | 2007-07-08 |