| NPI | 1427219799 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: MS 21922) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: AL 31130) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-06-19 |
| Last Update Date | 2022-10-11 |