| NPI | 1750519153 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: ND 13280) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MI 4301095896) |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: MI 4301095896) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-06-24 |
| Last Update Date | 2014-07-18 |