| NPI | 1669869574 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WA MD60942220) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MT 104681) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: ID MC-1231) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: OR MD208481) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: AK 186740) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A177502) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX T7069) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NM TM2022-0410) | |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: WA MD60942220) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-04-17 |
| Last Update Date | 2022-07-22 |