| NPI | 1518221357 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: AL 36292) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: GA 86626) |
| 2084V0102X Psychiatry & Neurology Vascular Neurology (Licence: GA 86626) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-06-26 |
| Last Update Date | 2020-10-06 |