NPI | 1275629719 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA MD60076901) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: ND 10292) |
Enumeration Date | 2006-10-04 |
Last Update Date | 2019-10-24 |