NPI | 1578927679 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NV DO3037) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI 5101022812) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2016-04-05 |
Last Update Date | 2023-06-05 |