| NPI | 1154873917 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: IL 036153123) |
| Additional Taxonomies | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: MO 2023036493) |
| 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: IN 01091726A) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 57028154) | |
| Enumeration Date | 2016-10-27 |
| Last Update Date | 2023-10-27 |