| NPI | 1194840231 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA G41219) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO 21195) |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2024-09-19 |