| NPI | 1558565358 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CO DR.0059446) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35.098114) |
| 207P00000X Emergency Medicine (Licence: MD D70363) | |
| 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: NC 141986) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 35.098114) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: KY TP878) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101280536) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2024-03-06 |