| NPI | 1598903858 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A109162) |
| Additional Taxonomies | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: CA A109162) |
| 2084P0805X (Licence: CA A109162) | |
| Enumeration Date | 2009-01-25 |
| Last Update Date | 2021-05-21 |