| NPI | 1649891912 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: KS Pending) |
| Enumeration Date | 2020-04-28 |
| Last Update Date | 2024-04-03 |