NPI | 1912049909 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: PR 4353) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PR 4353) |
Enumeration Date | 2007-02-13 |
Last Update Date | 2011-09-30 |