| NPI | 1033538459 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA 20A24058) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL OS16532) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 2022-02745) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0102204464) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA OP61329860) | |
| Enumeration Date | 2014-04-14 |
| Last Update Date | 2025-10-27 |