NPI | 1265828214 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: NM MD2020-0800) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NM RS2015-0505) |
Enumeration Date | 2015-04-07 |
Last Update Date | 2024-03-08 |