NPI | 1952629917 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT197367) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MT197367) |
Enumeration Date | 2010-05-14 |
Last Update Date | 2013-06-25 |