NPI | 1578909826 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX R0165) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD462025) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2013-05-14 |
Last Update Date | 2022-05-08 |