NPI | 1871121418 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 174400000X Specialist (Licence: CA PTL5327) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA PTL5327) |
390200000X Student in an Organized Health Care Education/Training Program (Licence: CA PTL5327) | |
Enumeration Date | 2020-03-30 |
Last Update Date | 2022-12-21 |