| NPI | 1871097444 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TN 76108) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WA MD61530887) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME163097) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A179767) | |
| Enumeration Date | 2018-03-20 |
| Last Update Date | 2026-04-16 |