NPI | 1346732450 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA 179215) |
Additional Taxonomies | 174400000X Specialist (Licence: CA 179215) |
208D00000X General Practice (Licence: CA 179215) | |
Enumeration Date | 2018-06-04 |
Last Update Date | 2023-07-26 |