NPI | 1326230749 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA 20A15663) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CO 49137) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CO 2301) | |
Enumeration Date | 2007-08-10 |
Last Update Date | 2023-05-18 |