| NPI | 1669005567 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA 199320) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GA 89896) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA SPI711) | |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: CA SPI711) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-02-19 |
| Last Update Date | 2024-10-17 |