| NPI | 1043283955 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: CA C148173) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: CO 49632) |
| Enumeration Date | 2006-02-10 |
| Last Update Date | 2022-02-04 |