| NPI | 1093159444 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TN 55683) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2024045767) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME168010) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35C.001548) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-04-28 |
| Last Update Date | 2025-01-08 |