| NPI | 1497173694 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A154761) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI 4301107569) |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: CA A154761) | |
| Enumeration Date | 2014-04-03 |
| Last Update Date | 2024-03-26 |