NPI | 1801019534 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA a111247) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA R6903) |
207R00000X Internal Medicine (Licence: IA 37227) | |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IA 37227) | |
Enumeration Date | 2007-04-11 |
Last Update Date | 2011-08-04 |