| NPI | 1023194289 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: CA G176220) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: AZ 25421) |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: AZ 25421) | |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2022-04-21 |