| NPI | 1326230749 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA 20A15663) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CO 49137) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CO 2301) | |
| Enumeration Date | 2007-08-10 |
| Last Update Date | 2023-05-18 |