NPI | 1962635524 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101043896) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD D0043377) |
Enumeration Date | 2009-08-31 |
Last Update Date | 2009-08-31 |