| NPI | 1417419441 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: GA pending) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301507152) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-03-31 |
| Last Update Date | 2023-06-19 |