| NPI | 1750605770 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: LA MD.205757) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: LA MD.205757) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-03-19 |
| Last Update Date | 2023-04-26 |