| NPI | 1205106382 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A175834) |
| Additional Taxonomies | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: CA A175834) |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: CA A175834) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: CA A175834) | |
| Enumeration Date | 2012-01-06 |
| Last Update Date | 2023-01-12 |