NPI | 1912250440 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA G6757) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: HI MD6920) |
Enumeration Date | 2012-10-22 |
Last Update Date | 2024-08-31 |