| NPI | 1649775503 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME163080) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME163080) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: OR MD221486) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: WA MD61552547) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-03-24 |
| Last Update Date | 2025-02-06 |