NPI | 1932401502 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA G46301) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AZ AG1447463) |
Enumeration Date | 2010-12-02 |
Last Update Date | 2010-12-02 |