| NPI | 1801090006 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA C147508) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA C147508) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 2010-02091) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: OR MD180163) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX M6752) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 2010-02091) | |
| Enumeration Date | 2007-06-12 |
| Last Update Date | 2022-07-20 |