| NPI | 1760986087 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA a188227) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A188227) |
| Enumeration Date | 2018-03-21 |
| Last Update Date | 2024-08-13 |