NPI | 1568098556 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A179243) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MT MED-PHYS-LIC-146390) |
Enumeration Date | 2020-03-21 |
Last Update Date | 2025-05-06 |