| NPI | 1790139905 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: AZ 011067) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: CO DR.0073073) |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: NE 1787) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-04-14 |
| Last Update Date | 2024-10-01 |