NPI | 1821180605 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: CT 023478) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: NY 156828) |
Enumeration Date | 2006-09-29 |
Last Update Date | 2007-07-08 |