NPI | 1518490606 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: KY 56091) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: KY R4691) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2017-04-06 |
Last Update Date | 2022-09-20 |