| NPI | 1700377181 |
|---|---|
| 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: IL 125.078734) |
| Enumeration Date | 2018-05-22 |
| Last Update Date | 2024-05-05 |