| NPI | 1962638536 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 265488) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A100236) |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: CA A100236) | |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: MA 265488) | |
| Enumeration Date | 2009-06-09 |
| Last Update Date | 2016-02-26 |