NPI | 1255622015 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101268956) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 2016-01188) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2011-04-28 |
Last Update Date | 2023-06-15 |