NPI | 1801001136 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA mt187199) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD436963) |
Enumeration Date | 2007-05-11 |
Last Update Date | 2015-03-23 |