| NPI | 1962963710 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: CA 177512) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA PTL1040) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A177512) | |
| Enumeration Date | 2019-03-26 |
| Last Update Date | 2023-06-06 |