NPI | 1952693376 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 271039) |
Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: MA 271039) |
2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: RI MD15947) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2011-05-03 |
Last Update Date | 2022-10-11 |