| NPI | 1891182564 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GA 83336) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: DC MD200001387) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101274624) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD d0095854) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-04-21 |
| Last Update Date | 2023-10-03 |