NPI | 1083019574 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: OR DO209910) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: WA OP61276957) |
390200000X Student in an Organized Health Care Education/Training Program | |
2084N0400X Psychiatry & Neurology Neurology (Licence: OH 34.014066) | |
Enumeration Date | 2014-10-27 |
Last Update Date | 2024-04-05 |