| NPI | 1265458087 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: CA G75488) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA G75488) |
| 2084P0805X (Licence: CA G75488) | |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2013-01-30 |