NPI | 1083677686 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: CA G027561) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: CA G027561) |
Enumeration Date | 2006-04-06 |
Last Update Date | 2016-09-02 |