NPI | 1104184167 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084N0008X Psychiatry & Neurology, Neuromuscular Medicine (Licence: CT 56550) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 285553) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2012-04-27 |
Last Update Date | 2022-07-21 |