NPI | 1952385130 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA OP00002259) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 203646) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ MB08033400) | |
Enumeration Date | 2005-12-01 |
Last Update Date | 2007-09-13 |