| NPI | 1811181696 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD468458) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI 4301500734) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: KS 0437211) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: ND 20693) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AZ 61826) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MO 2010014088) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-09-05 |
| Last Update Date | 2023-09-19 |