| NPI | 1104323542 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA OS023130) |
| Additional Taxonomies | 2084S0012X Psychiatry & Neurology, Sleep Medicine (Licence: PA OS023130) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-04-11 |
| Last Update Date | 2023-08-22 |