| NPI | 1144727504 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: PA OS024046) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: DC DO210001664) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD H0094679) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-04-11 |
| Last Update Date | 2025-12-26 |