| NPI | 1245520352 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084F0202X Psychiatry & Neurology Forensic Psychiatry (Licence: MS 24449) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: MS 24449) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-04-10 |
| Last Update Date | 2023-01-06 |