| NPI | 1992233175 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A184077) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AZ 61727) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NV 21193) | |
| Enumeration Date | 2017-05-31 |
| Last Update Date | 2026-02-17 |