| NPI | 1689942443 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A123174) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: CA A123174) |
| 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: CA A123174) | |
| Enumeration Date | 2011-12-08 |
| Last Update Date | 2026-05-05 |