NPI | 1255835633 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA 20A18157) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 2023-01890) |
Enumeration Date | 2018-03-21 |
Last Update Date | 2025-06-27 |