| NPI | 1619498557 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: HI MD22897) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MO 2020031778) |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: MO 2020031778) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-06-30 |
| Last Update Date | 2022-10-07 |