NPI | 1881702744 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GA 59699) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: SC TL27350) |
Enumeration Date | 2006-08-29 |
Last Update Date | 2011-10-10 |