| NPI | 1326302894 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 315938) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MD D0082465) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MS 839-L) | |
| Enumeration Date | 2012-06-29 |
| Last Update Date | 2022-07-21 |