| NPI | 1639481872 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: PA MD452926) |
| Additional Taxonomies | 2084N0008X Psychiatry & Neurology Neuromuscular Medicine (Licence: PA MD452926) |
| 2084N0600X Psychiatry & Neurology Clinical Neurophysiology (Licence: PA MD452926) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT197704) | |
| Enumeration Date | 2010-07-03 |
| Last Update Date | 2020-08-30 |