| NPI | 1740549922 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: NY 272550) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 272550) | |
| Enumeration Date | 2012-05-09 |
| Last Update Date | 2023-03-07 |