| NPI | 1134674872 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: PA MD482109) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 4301508498) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: AL L.4390R) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: AZ R76852) | |
| Enumeration Date | 2016-08-23 |
| Last Update Date | 2023-08-01 |