| NPI | 1811314826 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NM MD2023-0473) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MA 272765) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL TRN28090) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NM RS2014-0218) | |
| Enumeration Date | 2014-03-27 |
| Last Update Date | 2024-06-28 |