| NPI | 1215969597 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: CA G20816) |
| Additional Taxonomies | 2084P0802X Psychiatry & Neurology Addiction Psychiatry (Licence: CA G20816) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2015-01-12 |