| NPI | 1477895860 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX T5045) |
| Additional Taxonomies | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: CA A155283) |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: TX T5045) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A155283) | |
| Enumeration Date | 2013-03-23 |
| Last Update Date | 2026-01-20 |