NPI | 1972577641 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: CO 20894) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: CA G46955) |
Enumeration Date | 2006-02-17 |
Last Update Date | 2007-07-08 |