NPI | 1659712545 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OK 29909) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OK 29909) |
Enumeration Date | 2013-07-09 |
Last Update Date | 2018-03-26 |