| NPI | 1295802700 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A4150) |
| Additional Taxonomies | 208D00000X General Practice (Licence: CA A41530) |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2023-06-05 |