| 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 |