NPI | 1891358784 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MN 73675) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 250204) |
Enumeration Date | 2019-04-17 |
Last Update Date | 2024-07-03 |