| NPI | 1710654868 |
|---|---|
| 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: SD 17923) |
| Enumeration Date | 2021-08-26 |
| Last Update Date | 2026-06-05 |