| NPI | 1255362893 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA C129192) |
| Additional Taxonomies | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: CT 041608C) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CT 041608) | |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: CA C129192) | |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2021-08-25 |