| NPI | 1598922130 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: SC 33281) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 2084D0003X Psychiatry & Neurology, Diagnostic Neuroimaging (Licence: SC 33281-2015) | |
| Enumeration Date | 2008-05-21 |
| Last Update Date | 2016-06-15 |