NPI | 1306045281 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A133438) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0116019347) |
Enumeration Date | 2007-07-12 |
Last Update Date | 2024-10-22 |