NPI | 1902149248 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NV 16431) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: LA MD.207143) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: LA PGY.202293) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2013-04-05 |
Last Update Date | 2022-03-17 |