| NPI | 1013969161 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: CA A45202) |
| Additional Taxonomies | 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: CA A45202) |
| 2084P0805X (Licence: CA A45202) | |
| 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: CA A45202) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A45202) | |
| 2084P0005X Psychiatry & Neurology, Neurodevelopmental Disabilities (Licence: CA A45202) | |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2026-04-07 |