| NPI | 1922051846 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A84300) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NV 15135) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: NV 15135) | |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2024-08-26 |