| NPI | 1972644300 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA G190241) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA G19024) |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2023-03-07 |