| NPI | 1235426347 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NJ 25MA09561000) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME126459) |
| 208D00000X General Practice (Licence: AZ 48147) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: AZ AU-29035998302) | |
| Enumeration Date | 2011-07-09 |
| Last Update Date | 2024-09-26 |