NPI | 1225118359 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AZ 2368) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA OS004221-L) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WV 701) | |
Enumeration Date | 2006-10-16 |
Last Update Date | 2007-07-08 |