NPI | 1598875544 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CT 34678) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: LA 12430R) |
Enumeration Date | 2006-08-30 |
Last Update Date | 2020-02-20 |