| NPI | 1578729588 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA a123402)  | 
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: NY 244557)  | 
| Enumeration Date | 2008-07-30 | 
| Last Update Date | 2015-03-20 |