| NPI | 1538503131 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 4301111757) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NH 20702) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MT 99195) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2020006664) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX T3605) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD473920) | |
| Enumeration Date | 2013-04-25 |
| Last Update Date | 2024-04-05 |