| NPI | 1073876298 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: HI MD-19071) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207R00000X Internal Medicine (Licence: IL 125061931) | |
| Enumeration Date | 2012-06-21 |
| Last Update Date | 2021-05-24 |