| NPI | 1366416489 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: UT 280161-1205) |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology Addiction Medicine (Licence: UT 280161-1205) |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: CA A84151) | |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2022-07-21 |