| NPI | 1801098967 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA 132723) |
| Additional Taxonomies | 2084P0015X Psychiatry & Neurology, Psychosomatic Medicine (Licence: CA 132723) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OR MD29256) | |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: CA 132723) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: CA 132723) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CO DR.0051514) | |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2026-05-18 |