| NPI | 1235767153 |
|---|---|
| Other Name | CODY MATTHEW HALSTED |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AR E-16098) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2020-03-27 |
| Last Update Date | 2024-04-17 |