| NPI | 1861417628 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: CA A104000) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A104000) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: WA MD00045172) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA MD00045172) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: NY 25944) | |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2025-10-13 |