| NPI | 1376706705 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A130867) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: SC LL30847) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: SC LL30847) | |
| Enumeration Date | 2008-07-07 |
| Last Update Date | 2017-01-23 |