| NPI | 1902259880 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1744R1102X Specialist, Research Study |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA 20A18101) |
| Enumeration Date | 2016-07-15 |
| Last Update Date | 2025-10-08 |