| NPI | 1326540337 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NV NVSL1618) |
| Enumeration Date | 2018-03-06 |
| Last Update Date | 2024-04-12 |