| NPI | 1225569759 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CT 71176) |
| Additional Taxonomies | 2084E0001X Psychiatry & Neurology, Epilepsy (Licence: CT 71176) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-03-26 |
| Last Update Date | 2022-06-06 |