| NPI | 1811421407 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: UT 12171541-1204) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: AR E-11688) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-04-20 |
| Last Update Date | 2021-06-21 |