NPI | 1235559667 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 2018-00814) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: AZ D02698178) |
Enumeration Date | 2014-04-24 |
Last Update Date | 2019-03-27 |