| NPI | 1295954220 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA G11154) |
| Additional Taxonomies | 102L00000X Psychoanalyst (Licence: CA G11154) |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2014-08-05 |