| NPI | 1255530820 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: TX P0119) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX P0119) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: OK 29499) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-07-13 |
| Last Update Date | 2021-01-26 |