| NPI | 1275574501 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: CA G20335) |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: CA DEAAM6705593) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2007-12-28 |