| NPI | 1669564175 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TP0814X Psychologist, Psychoanalysis |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA C35318) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: CA C35318) | |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2009-10-06 |