| NPI | 1841635422 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OR MD215257) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX T7796) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME157513) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MD D0083674) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2024035389) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-05-08 |
| Last Update Date | 2024-09-12 |