| NPI | 1588862262 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: CA A95784) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: CA A95784) |
| 2084P0015X Psychiatry & Neurology Psychosomatic Medicine (Licence: CA A95784) | |
| Enumeration Date | 2007-07-05 |
| Last Update Date | 2012-04-10 |