| NPI | 1871034728 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IA MD-46387) |
| 208D00000X General Practice (Licence: IA MD-46387) | |
| Enumeration Date | 2017-03-11 |
| Last Update Date | 2024-04-08 |