NPI | 1437382389 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA MD61156718) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301093049) |
Enumeration Date | 2009-08-26 |
Last Update Date | 2021-09-03 |