NPI | 1427506955 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A157092) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CT 67556) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2016-09-13 |
Last Update Date | 2022-10-18 |