NPI | 1134675499 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35.140346) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2016-08-28 |
Last Update Date | 2022-08-12 |