NPI | 1114508256 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: IL 125078128) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.078128) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2021-04-20 |
Last Update Date | 2022-06-01 |