NPI | 1568029601 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084E0001X Psychiatry & Neurology, Epilepsy (Licence: SC 91687) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2019-05-23 |
Last Update Date | 2024-10-07 |