| NPI | 1346732450 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA 179215) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA 179215) |
| 208D00000X General Practice (Licence: CA 179215) | |
| Enumeration Date | 2018-06-04 |
| Last Update Date | 2023-07-26 |