| NPI | 1104472182 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS59615) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CO 0000000000) | |
| Enumeration Date | 2019-08-14 |
| Last Update Date | 2024-04-11 |