NPI | 1679951107 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: MT 141019) |
Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: WA 60849311) |
2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: AK 222922) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2015-05-17 |
Last Update Date | 2024-11-15 |