| NPI | 1215431036 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CO CDR.0005484) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NV LL3148) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207R00000X Internal Medicine (Licence: NV 27088) | |
| Enumeration Date | 2018-03-19 |
| Last Update Date | 2025-10-31 |