NPI | 1902433402 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: NV 3206) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2020-03-25 |
Last Update Date | 2024-06-25 |