NPI | 1235330523 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OK 28489) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: KS 04-47545) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI 4301089814) | |
390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301089814) | |
Enumeration Date | 2007-05-31 |
Last Update Date | 2023-12-11 |