| NPI | 1649511486 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD D0092247) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A132683) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101272404) | |
| Enumeration Date | 2013-03-04 |
| Last Update Date | 2021-10-27 |