| NPI | 1750794087 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IN 02006511A) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036166332) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL OS14445) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL U03897) | |
| Enumeration Date | 2014-06-04 |
| Last Update Date | 2024-09-24 |