| NPI | 1386878247 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA C166152) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 244648) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 254410) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-05-07 |
| Last Update Date | 2022-05-24 |