| NPI | 1255592721 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: CA A95686) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A95686) |
| Enumeration Date | 2008-06-18 |
| Last Update Date | 2023-05-11 |