NPI | 1457735060 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A161174) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: KY R3879) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: KY 51186) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2015-07-13 |
Last Update Date | 2023-09-07 |