| NPI | 1386938082 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA 20A13416) |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: AK 145695) |
| 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: CA 20A13416) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AK 145695) | |
| Enumeration Date | 2011-05-31 |
| Last Update Date | 2020-04-24 |