NPI | 1457812349 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A177716) |
Additional Taxonomies | 174400000X Specialist (Licence: CA 177716) |
Enumeration Date | 2019-03-25 |
Last Update Date | 2024-02-15 |