| NPI | 1851954226 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: AZ 71098) |
| Additional Taxonomies | 2084N0600X (Licence: IL 036.164253) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-04-20 |
| Last Update Date | 2025-11-18 |