NPI | 1336534106 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A144731) |
Additional Taxonomies | 174400000X Specialist (Licence: CA A144731) |
2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: CA A144731) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2015-03-30 |
Last Update Date | 2023-05-25 |