| NPI | 1376047282 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084V0102X Psychiatry & Neurology Vascular Neurology (Licence: KY 58247) |
| Additional Taxonomies | 2084V0102X Psychiatry & Neurology Vascular Neurology (Licence: KY TP452) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-03-23 |
| Last Update Date | 2023-10-25 |