| NPI | 1558998542 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A177063) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: CA A177063) | |
| Enumeration Date | 2020-03-27 |
| Last Update Date | 2023-08-02 |