| NPI | 1053871681 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A201260) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NV 24103) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 1053871681) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 33483301) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CO DR0074611) | |
| Enumeration Date | 2019-03-20 |
| Last Update Date | 2025-10-23 |