| NPI | 1295702710 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A73152) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA A73152) |
| Enumeration Date | 2006-03-02 |
| Last Update Date | 2019-02-07 |