| NPI | 1912106717 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A107376) |
| Additional Taxonomies | 2084B0002X Psychiatry & Neurology, Bariatric Medicine (Licence: CA A107376) |
| Enumeration Date | 2007-07-12 |
| Last Update Date | 2018-05-08 |