NPI | 1285254615 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI 4301511902) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 5315216407) |
Enumeration Date | 2020-04-27 |
Last Update Date | 2025-08-13 |