NPI | 1962421529 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA C51675) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 35-043662) |
Enumeration Date | 2006-07-18 |
Last Update Date | 2018-01-26 |