| NPI | 1083243125 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A180999) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101278037) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD D0097032) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: DC MD210011573) | |
| Enumeration Date | 2020-04-01 |
| Last Update Date | 2023-06-22 |