| NPI | 1144684374 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA md477635) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MA 268810) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35.142217) | |
| 208D00000X General Practice (Licence: OH 35.142217) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-04-13 |
| Last Update Date | 2024-02-22 |