| NPI | 1932774577 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI 5101027555) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 5151014955) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 5101027555) | |
| Enumeration Date | 2021-05-25 |
| Last Update Date | 2026-03-24 |