NPI | 1073911251 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 294098) |
Additional Taxonomies | 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: NY 294098) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2014-12-20 |
Last Update Date | 2019-05-13 |