NPI | 1366881757 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA 20A15626) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL UO3102) |
Enumeration Date | 2013-06-18 |
Last Update Date | 2018-07-26 |