| NPI | 1528220720 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: CA A146354) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: KS 94-7047) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 54526) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-06-28 |
| Last Update Date | 2022-07-21 |