| NPI | 1780751735 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: CA A50719) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: CA A50719) |
| 2084B0040X Psychiatry & Neurology Behavioral Neurology & Neuropsychiatry (Licence: CA A93179) | |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2013-07-25 |