| NPI | 1114314127 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 278927) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL TPME364) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 87075) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: KY 54401) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 2020-03235) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: IN 01084334A) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-04-17 |
| Last Update Date | 2021-03-30 |