| NPI | 1518392323 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CT 062662) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CT 062662) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-09-11 |
| Last Update Date | 2022-06-29 |