NPI | 1083751374 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: AL 27840) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CO DR-44386) |
Enumeration Date | 2007-01-30 |
Last Update Date | 2007-07-12 |