NPI | 1861998130 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A163339) |
Additional Taxonomies | 174400000X Specialist (Licence: CA A163339) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2018-04-04 |
Last Update Date | 2023-06-12 |