| NPI | 1407829286 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: CA C52121) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA MD051151L) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA C52121) | |
| Enumeration Date | 2006-02-10 |
| Last Update Date | 2024-04-30 |