NPI | 1245376615 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A98911) |
Additional Taxonomies | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: CA a98911) |
2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: CA A98911) | |
Enumeration Date | 2007-01-30 |
Last Update Date | 2019-03-18 |