NPI | 1518609486 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A195131) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 210847) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA G143626) | |
Enumeration Date | 2022-04-11 |
Last Update Date | 2025-06-16 |