NPI | 1932318078 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OR MD154637) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AZ 38004) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A111108) | |
Enumeration Date | 2007-05-22 |
Last Update Date | 2021-03-10 |