NPI | 1851910442 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CO DR.0070461) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CO TL0008242) |
Enumeration Date | 2020-04-13 |
Last Update Date | 2024-02-28 |