| NPI | 1447570031 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A 118905) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OR MD191022) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NV 18989) | |
| Enumeration Date | 2010-06-04 |
| Last Update Date | 2019-08-13 |