| NPI | 1003017427 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL MD127398) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD466189) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: WA MD60365989) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 4301114445) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 2016-00670) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NE 29193) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 292709) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX N2178) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NH 17836) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2020003929) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL TRN8973) | |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2023-08-29 |