| NPI | 1013587849 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: MO 1013587849) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MO 2021023810) | |
| Enumeration Date | 2021-06-24 |
| Last Update Date | 2022-06-27 |