NPI | 1811962384 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: TX L0369) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: CO CDR.0002720) |
Enumeration Date | 2006-02-20 |
Last Update Date | 2023-07-01 |