| NPI | 1417935255 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: CA a105316) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 224157) |
| Enumeration Date | 2006-01-03 |
| Last Update Date | 2022-07-21 |