| NPI | 1518387398 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OR MD218422) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MT MED-PHYS-LIC-77300) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 201814) | |
| Enumeration Date | 2014-04-21 |
| Last Update Date | 2024-01-02 |