NPI | 1548840614 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC RTL21-1150) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC RTL) |
Enumeration Date | 2021-04-12 |
Last Update Date | 2024-06-07 |