| NPI | 1063594687 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: CA A85828) |
| Additional Taxonomies | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: CA A85828) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A85828) | |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2010-01-13 |