| NPI | 1528199361 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA G26189) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA G26189) |
| 173000000X Legal Medicine (Licence: CA G26189) | |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2008-02-21 |