| NPI | 1497334965 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CA A202833) |
| Additional Taxonomies | 2084N0600X (Licence: CA A202833) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A202833) | |
| Enumeration Date | 2021-04-03 |
| Last Update Date | 2025-12-10 |