NPI | 1760913867 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084E0001X Psychiatry & Neurology, Epilepsy (Licence: CA 187347) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2017-03-21 |
Last Update Date | 2023-10-27 |