| NPI | 1154814986 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: NE 33163) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NE 33163) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-06-06 |
| Last Update Date | 2024-02-29 |