| NPI | 1679060370 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101275205) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME149460) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD D0094297) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 35.146287) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: DE C1-0025484) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD479594) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 2022-02726) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-04-18 |
| Last Update Date | 2023-06-28 |