NPI | 1821521279 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: PA OS021227) |
Additional Taxonomies | 208000000X Pediatrics (Licence: OR DO197940) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA OS021227) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2017-04-04 |
Last Update Date | 2021-07-13 |