NPI | 1871835900 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX S9728) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MN 59734) |
390200000X Student in an Organized Health Care Education/Training Program (Licence: MN 59734) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2013-03-27 |
Last Update Date | 2022-11-11 |