| NPI | 1184129512 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 34.016298) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OR DO208115) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-03-27 |
| Last Update Date | 2023-05-16 |