| NPI | 1932237450 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA G76011) |
| Additional Taxonomies | 283Q00000X Psychiatric Hospital (Licence: SC 12289) |
| 283Q00000X Psychiatric Hospital (Licence: CA G76011) | |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2020-07-07 |