NPI | 1275554735 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NV 16899) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: UT 1738911205) |
Enumeration Date | 2006-07-21 |
Last Update Date | 2019-11-14 |