NPI | 1073967782 |
---|---|
Former Name | SAN BYUNG KWAK |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AL 41865) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2016-04-19 |
Last Update Date | 2021-03-16 |