| NPI | 1245231133 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GA 71040) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A97128) |
| 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: CA A97128) | |
| Enumeration Date | 2005-08-02 |
| Last Update Date | 2023-11-06 |