| NPI | 1538540711 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A162429) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA MD60763221) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OR MD196772) | |
| Enumeration Date | 2015-06-14 |
| Last Update Date | 2026-04-08 |