NPI | 1669748489 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CO CDRH.0061622) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 34.0011573) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2012-03-26 |
Last Update Date | 2022-08-24 |