NPI | 1518080407 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME48497) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME48497) |
Enumeration Date | 2007-04-07 |
Last Update Date | 2012-08-03 |