| NPI | 1891228144 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA 20A19128) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: LA 312652) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: LA 000000000) | |
| Enumeration Date | 2017-04-04 |
| Last Update Date | 2024-12-24 |