| NPI | 1689942443 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: CA A123174) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A123174) |
| Enumeration Date | 2011-12-08 |
| Last Update Date | 2026-04-28 |