| NPI | 1497318646 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: AR E-15727) |
| 208D00000X General Practice (Licence: WV 34330) | |
| 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: AR E-15727) | |
| Enumeration Date | 2019-04-15 |
| Last Update Date | 2024-09-26 |