| NPI | 1346627551 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OR DO191028) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA Do.OP.61107091-imlc) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: UT 12573352-1204) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AZ 007117) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-04-27 |
| Last Update Date | 2022-04-28 |