| NPI | 1508245770 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 35.143409) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IN 11018106A) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IN 01078397A) | |
| Enumeration Date | 2015-05-21 |
| Last Update Date | 2024-11-20 |