| NPI | 1346761947 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AL 42769) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX U1684) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10061363) | |
| Enumeration Date | 2017-07-05 |
| Last Update Date | 2023-04-20 |