| NPI | 1083032809 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A142323) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125-065307) |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: SC 83186) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-03-29 |
| Last Update Date | 2021-12-20 |