NPI | 1770163040 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A184386) |
Additional Taxonomies | 174400000X Specialist |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2021-04-12 |
Last Update Date | 2023-07-20 |