NPI | 1508949496 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: MD D79744) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: NY 228003) |
Enumeration Date | 2006-10-23 |
Last Update Date | 2019-10-31 |