NPI | 1407911662 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA G30941) |
Additional Taxonomies | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: CA G30941) |
2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: CA G30941) | |
Enumeration Date | 2006-12-27 |
Last Update Date | 2021-11-20 |