NPI | 1891754040 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: AR C5579) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AR C5579) |
Enumeration Date | 2006-03-17 |
Last Update Date | 2007-08-14 |