NPI | 1932472883 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A123663) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GA 104204) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME157962) | |
Enumeration Date | 2012-02-22 |
Last Update Date | 2025-08-04 |