NPI | 1609496066 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: IL 036.164418) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125075488) |
390200000X Student in an Organized Health Care Education/Training Program (Licence: IL 125.075488) | |
Enumeration Date | 2020-04-25 |
Last Update Date | 2024-06-12 |