| NPI | 1346436276 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: DC MD040014) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101256170) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: UT 9374505-1205) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 149291) | |
| Enumeration Date | 2007-09-25 |
| Last Update Date | 2018-07-31 |