| NPI | 1497858476 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI 4301077953) |
| Additional Taxonomies | 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: MI 4301077953) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301077953) | |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2007-07-09 |