| NPI | 1013950708 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA C152398) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CO DR.0019032) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX E1083) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CO 19032) | |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2022-03-21 |