| NPI | 1902813157 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A67412) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GA 057056) |
| 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: CA A67412) | |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2014-10-10 |