| NPI | 1396092250 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: DC MD047385) |
| Additional Taxonomies | 207ZC0006X Pathology, Clinical Pathology (Licence: PA MD459051) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT202623) | |
| Enumeration Date | 2012-08-10 |
| Last Update Date | 2019-09-10 |