| NPI | 1801913322 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 67138-20) |
| Additional Taxonomies | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: MI 4301087852) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301087852) | |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2021-01-26 |