NPI | 1487175188 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 330428) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: RI MD17550) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2017-07-03 |
Last Update Date | 2025-04-25 |