| NPI | 1700248937 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 305375) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MT 100381) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NH 21791) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA OS022214) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2021045543) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-03-26 |
| Last Update Date | 2023-08-30 |