NPI | 1366762106 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A120199) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH AC2822890-K10-018) |
Enumeration Date | 2010-06-03 |
Last Update Date | 2023-03-07 |