| NPI | 1467522813 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A50066) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OR MD180816) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 198053) | |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2020-09-08 |