NPI | 1861698854 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101244106) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: unlicensed, trainee) |
Enumeration Date | 2007-06-26 |
Last Update Date | 2016-06-13 |