| NPI | 1154637593 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 2017-00250) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: NC 2017-00250) | |
| Enumeration Date | 2010-08-23 |
| Last Update Date | 2020-10-27 |