| NPI | 1093394058 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OR MD227293) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: WA MD70032263) | |
| Enumeration Date | 2021-04-06 |
| Last Update Date | 2025-10-16 |