| NPI | 1790028769 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 80242) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA 61098) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: KS 04-41999) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: OK 37207) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2019015696) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: AR E-12152) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX TM00838) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-03-28 |
| Last Update Date | 2023-04-12 |