| NPI | 1649767732 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NV DO3406) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10063735) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX T6060) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX T6060) | |
| Enumeration Date | 2018-04-16 |
| Last Update Date | 2023-11-07 |