| NPI | 1285139105 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: PA MD483725) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: MD D0095137) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-03-25 |
| Last Update Date | 2024-08-28 |