NPI | 1275094492 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: KY 58611) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: KY TP662) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2019-03-29 |
Last Update Date | 2023-10-25 |