NPI | 1346761947 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AL 42769) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10061363) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX U1684) | |
Enumeration Date | 2017-07-05 |
Last Update Date | 2024-08-27 |