NPI | 1366783532 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: NY 284204) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2013-03-12 |
Last Update Date | 2018-03-17 |