| NPI | 1437367414 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: VA 0101238515) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101238515) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0101238515) | |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: VA 0101238515) | |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2025-08-21 |