| NPI | 1881334308 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A189333) |
| Additional Taxonomies | 273R00000X Psychiatric Unit (Licence: CA A189333) |
| Enumeration Date | 2022-03-31 |
| Last Update Date | 2026-06-24 |