| NPI | 1447271242 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA 00G549970) |
| Additional Taxonomies | 2084P0805X (Licence: CA 00G549970) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2017-04-13 |