NPI | 1669979654 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: CO DR0065381) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME163265) | |
Enumeration Date | 2018-04-07 |
Last Update Date | 2024-05-22 |