| NPI | 1841455763 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MD D99486) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10032774) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX Q4914) | |
| Enumeration Date | 2008-07-21 |
| Last Update Date | 2024-02-29 |