| NPI | 1568488963 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA G56308) |
| Additional Taxonomies | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: CA G56308) |
| 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: CA G56308) | |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2007-07-08 |