| NPI | 1588276349 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AZ RNP318159) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: AZ RN154299) |
| Enumeration Date | 2020-08-21 |
| Last Update Date | 2025-01-03 |