NPI | 1619138468 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A117141) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 251565) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX R0769) | |
Enumeration Date | 2008-06-24 |
Last Update Date | 2022-05-19 |