| NPI | 1669667200 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A68346) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: CA A68346) |
| 2084P0015X Psychiatry & Neurology, Psychosomatic Medicine (Licence: CA A68346) | |
| 2084P0805X (Licence: CA A68346) | |
| Enumeration Date | 2007-09-06 |
| Last Update Date | 2021-12-06 |