NPI | 1720615370 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A187721) |
Additional Taxonomies | 174400000X Specialist (Licence: CA A187721) |
390200000X Student in an Organized Health Care Education/Training Program (Licence: CA A187721) | |
Enumeration Date | 2020-03-24 |
Last Update Date | 2023-07-30 |