| NPI | 1386273027 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: CA A178832) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA PTL4543) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-04-04 |
| Last Update Date | 2023-06-13 |