NPI | 1356609119 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 174400000X Specialist (Licence: CA A127914) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A127914) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2012-04-30 |
Last Update Date | 2022-12-30 |