NPI | 1972553238 |
---|---|
Other Name | MICHEAL MASH MOON |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TP0016X Psychologist, Prescribing (Medical) (Licence: NM 0013C) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NM 609) |
Enumeration Date | 2006-05-10 |
Last Update Date | 2008-01-10 |