NPI | 1508985938 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: LA MD.201192) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: LA MD.201192) |
Enumeration Date | 2007-03-28 |
Last Update Date | 2007-07-08 |