| NPI | 1225416951 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MD H010004) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA OS018486) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA OT016509) | |
| Enumeration Date | 2015-05-14 |
| Last Update Date | 2024-07-08 |