NPI | 1720510357 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A178256) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25MA11322200) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2017-04-02 |
Last Update Date | 2023-04-12 |