| NPI | 1760877237 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A160859) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA A160859) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: CA A160859) | |
| Enumeration Date | 2015-04-01 |
| Last Update Date | 2024-07-16 |