NPI | 1821445412 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CT 62103) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CT 057501) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2016-05-24 |
Last Update Date | 2021-11-30 |