NPI | 1578912572 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: KY TP227) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OK 32256) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2016-06-09 |
Last Update Date | 2022-09-22 |