| NPI | 1508421488 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: MN 76419) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: SC LL84510) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-05-06 |
| Last Update Date | 2025-04-01 |