| NPI | 1275916207 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: HI MD-21230) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: HI MD21230) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OK 31377) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036.145755) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: IL 036.145755) | |
| Enumeration Date | 2015-07-08 |
| Last Update Date | 2023-11-22 |