| NPI | 1770102261 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: VA 0102207259) |
| Additional Taxonomies | 208D00000X General Practice (Licence: VA 0102207259) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-04-14 |
| Last Update Date | 2024-06-11 |