| NPI | 1447298625 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA G66949) |
| Additional Taxonomies | 2084P0805X (Licence: CA G66949) |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2019-10-22 |