| NPI | 1417290057 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: KY 50983) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: KY 50983) |
| 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: IN 01089013A) | |
| 2084E0001X Psychiatry & Neurology, Epilepsy (Licence: IN 01089013A) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: IN 01089013A) | |
| Enumeration Date | 2013-04-02 |
| Last Update Date | 2025-03-19 |