| NPI | 1639153372 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: CA G81077) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA G81077) |
| Enumeration Date | 2005-12-06 |
| Last Update Date | 2021-04-26 |