NPI | 1801878749 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: AL 28211) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: PA MD-073690-L) |
Enumeration Date | 2005-11-16 |
Last Update Date | 2014-09-05 |