NPI | 1730202391 |
---|---|
Entity Type | Individual |
Gender | N/A |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA a99547) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25IA12263100) |
Enumeration Date | 2007-04-09 |
Last Update Date | 2025-02-18 |