NPI | 1750724142 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: SC 40448) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2013-04-16 |
Last Update Date | 2020-10-20 |