| NPI | 1306109053 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084B0040X Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry (Licence: CA 141261) |
| Additional Taxonomies | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: CA 141261) |
| 2084P0301X Psychiatry & Neurology, Brain Injury Medicine (Licence: CA A141261) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA 141261) | |
| Enumeration Date | 2012-06-18 |
| Last Update Date | 2022-10-22 |