NPI | 1760010524 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: CA A202435) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD478371) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD478371v) | |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A202435) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2020-03-28 |
Last Update Date | 2025-08-18 |