NPI | 1194952861 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CO DR.0053429) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA OT012962) |
Enumeration Date | 2009-06-19 |
Last Update Date | 2014-07-30 |