NPI | 1760986087 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA a188227) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A188227) |
Enumeration Date | 2018-03-21 |
Last Update Date | 2024-08-13 |