| NPI | 1386039352 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: NY 289136) |
| Enumeration Date | 2015-04-06 |
| Last Update Date | 2021-05-21 |