NPI | 1437760949 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 81201-20) |
Additional Taxonomies | 208D00000X General Practice (Licence: FL ME158872) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2020-08-10 |
Last Update Date | 2024-09-09 |