| NPI | 1831753227 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35.147806) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 1831753227) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME161239) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-05-01 |
| Last Update Date | 2024-08-21 |