| NPI | 1750408548 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A116523) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 60 255763) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MO 2006018543) | |
| Enumeration Date | 2007-03-25 |
| Last Update Date | 2021-04-20 |