| NPI | 1346822673 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA 189124) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA PTL6535) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA PTL6535) | |
| Enumeration Date | 2021-04-26 |
| Last Update Date | 2026-05-26 |