| NPI | 1194304709 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 2084B0040X Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry (Licence: IL 036.173149) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 35.149223) | |
| Enumeration Date | 2021-04-02 |
| Last Update Date | 2025-02-17 |