NPI | 1497174023 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A136661) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
174400000X Specialist (Licence: CA A136661) | |
Enumeration Date | 2014-04-10 |
Last Update Date | 2016-08-01 |