| NPI | 1497802383 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA C178910) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CO DR.0068674) |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: WA MD60044426) | |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2022-07-11 |