| NPI | 1386910313 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IA MD-41722) |
| Enumeration Date | 2012-03-23 |
| Last Update Date | 2022-07-21 |