NPI | 1205445202 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: UT 13567920-1205) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10070415) |
Enumeration Date | 2020-07-24 |
Last Update Date | 2024-07-24 |