| NPI | 1013123280 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: CA A118331) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: NV 21617) | |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2022-04-21 |