| NPI | 1174176226 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2022025489) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 2084S0012X Psychiatry & Neurology, Sleep Medicine (Licence: MO 2022025489) | |
| Enumeration Date | 2019-07-18 |
| Last Update Date | 2022-07-26 |