| NPI | 1346629755 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA 17234) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: UT 11137175-1204) |
| Enumeration Date | 2015-05-19 |
| Last Update Date | 2024-05-17 |