NPI | 1922120740 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX H6976) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MS 06039) |
Enumeration Date | 2007-04-04 |
Last Update Date | 2010-07-19 |