| NPI | 1811196470 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: CA A88581) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: CA A88581) |
| 2084B0040X Psychiatry & Neurology Behavioral Neurology & Neuropsychiatry (Licence: CA A88581) | |
| 2084P0802X Psychiatry & Neurology Addiction Psychiatry (Licence: CA A88581) | |
| Enumeration Date | 2007-07-13 |
| Last Update Date | 2013-05-16 |