| NPI | 1639670037 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: TX T7020) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX T7020) |
| Enumeration Date | 2018-02-22 |
| Last Update Date | 2024-04-29 |