| NPI | 1841506227 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: SC 82278) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101255916) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-08-24 |
| Last Update Date | 2020-08-24 |