| NPI | 1396742367 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA g77605) |
| Additional Taxonomies | 102L00000X Psychoanalyst |
| Enumeration Date | 2005-07-05 |
| Last Update Date | 2025-07-15 |