NPI | 1225566102 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: CA A158631) |
Additional Taxonomies | 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: CA A158631) |
Enumeration Date | 2017-05-23 |
Last Update Date | 2022-07-08 |