| NPI | 1932715430 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 146N00000X Emergency Medical Technician, Basic (Licence: VT 105065) |
| Additional Taxonomies | 102L00000X Psychoanalyst (Licence: VT 097.0134992) |
| 102L00000X Psychoanalyst (Licence: 097.0134992) | |
| 146M00000X Emergency Medical Technician, Intermediate (Licence: VT 105065) | |
| 2084B0040X Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry (Licence: VT 097.0134992) | |
| Enumeration Date | 2020-09-20 |
| Last Update Date | 2021-05-14 |