NPI | 1588027973 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GA 79564) |
Additional Taxonomies | 208D00000X General Practice (Licence: GA 79564) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2016-04-01 |
Last Update Date | 2023-01-12 |