| NPI | 1255474979 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA C171643) |
| Additional Taxonomies | 2084P0015X Psychiatry & Neurology, Psychosomatic Medicine (Licence: CA C171643) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IA MD-41376) | |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2026-07-17 |