NPI | 1639193659 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA G83339) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 2013-01433) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD042185L) | |
Enumeration Date | 2006-07-26 |
Last Update Date | 2017-01-05 |