| NPI | 1932215654 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A69685) |
| Additional Taxonomies | 2084B0040X Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry (Licence: CA a69685) |
| 2084P0805X (Licence: CA A69685) | |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2019-06-29 |