NPI | 1649383563 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OR MD08904) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA MD00013124) |
Enumeration Date | 2006-08-16 |
Last Update Date | 2022-02-04 |