| NPI | 1427481498 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: MI 4301114253) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 4301114253) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: IL 125.063906) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX R3698) | |
| Enumeration Date | 2013-08-14 |
| Last Update Date | 2024-12-10 |