| NPI | 1033536073 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A138031) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA A138031) |
| Enumeration Date | 2014-03-27 |
| Last Update Date | 2021-11-29 |