| NPI | 1437371671 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A125259) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: ND 11691) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: KS 6691) | |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2022-03-07 |