| NPI | 1396366639 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IA R-11759) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IA MD-49306) |
| Enumeration Date | 2020-04-28 |
| Last Update Date | 2022-11-18 |