| NPI | 1275784233 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: CA A33434) |
| Additional Taxonomies | 207YX0007X Otolaryngology Plastic Surgery within the Head & Neck (Licence: CA A033434) |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: CA A033434) | |
| Enumeration Date | 2008-10-08 |
| Last Update Date | 2018-07-17 |