| NPI | 1891939260 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: CO DR.0053697) |
| Additional Taxonomies | 2084P0015X Psychiatry & Neurology Psychosomatic Medicine (Licence: WA 60337754) |
| 2084P0015X Psychiatry & Neurology Psychosomatic Medicine (Licence: CO 53697) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-04-28 |
| Last Update Date | 2024-01-03 |