NPI | 1043672421 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 1016768) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 301805) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 301805-01) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2016-03-24 |
Last Update Date | 2025-02-23 |