| NPI | 1255444840 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA G185295) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101031474) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD D26033) | |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2023-07-13 |