| NPI | 1982818480 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A116593) |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: MI 4301095166) |
| 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: CA A116593) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI 4301095166) | |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2019-08-15 |