NPI | 1225117799 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: IA 086078) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: UT 6053985-2501) |
Enumeration Date | 2006-11-03 |
Last Update Date | 2017-05-10 |