NPI | 1912079518 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A24509) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA MD0026639) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101030772) | |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TN 60455) | |
Enumeration Date | 2006-11-15 |
Last Update Date | 2021-05-18 |