| NPI | 1811158082 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: MD D0072179) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: FL ME118020) |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: GA 82841) | |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: LA 320637) | |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: CA C168659) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-06-20 |
| Last Update Date | 2024-06-13 |