NPI | 1760904239 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA 172488) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: DC MTL004043) |
Enumeration Date | 2017-07-16 |
Last Update Date | 2024-04-15 |