| NPI | 1285263186 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: DC MD500002962) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 57.249595) | |
| Enumeration Date | 2020-04-03 |
| Last Update Date | 2024-08-03 |