| NPI | 1174520241 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: CA G-027613) |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology Addiction Medicine (Licence: CA G-027613) |
| 2084P0802X Psychiatry & Neurology Addiction Psychiatry (Licence: CA G-027613) | |
| Enumeration Date | 2005-07-05 |
| Last Update Date | 2007-07-10 |