| NPI | 1306880463 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A30248) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A30248) |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2020-01-14 |