NPI | 1962963710 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 174400000X Specialist (Licence: CA 177512) |
Additional Taxonomies | 174400000X Specialist (Licence: CA PTL1040) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A177512) | |
Enumeration Date | 2019-03-26 |
Last Update Date | 2024-10-25 |