NPI | 1437688702 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: FL OS16880) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
2084P0800X Psychiatry & Neurology Psychiatry (Licence: CO TL0006538) | |
Enumeration Date | 2017-06-08 |
Last Update Date | 2023-01-30 |