| NPI | 1992988612 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA G56456) |
| Additional Taxonomies | 102L00000X Psychoanalyst |
| Enumeration Date | 2007-12-17 |
| Last Update Date | 2007-12-18 |