NPI | 1689673253 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA 118281) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0102026059) |
Enumeration Date | 2005-07-18 |
Last Update Date | 2022-11-25 |