NPI | 1265969646 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: FL ME154837) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: CA A172256) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2017-05-17 |
Last Update Date | 2022-08-03 |