| NPI | 1174643647 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: CA C55096) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: CA C55096) |
| 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: IL 036-108420) | |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2025-05-23 |