| NPI | 1043310808 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: NV 18234) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA CA34225512) |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: ID M-16339) | |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: CA A96451) | |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2024-05-13 |