| NPI | 1881122471 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 95567) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A172263) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA 271915) | |
| Enumeration Date | 2017-05-26 |
| Last Update Date | 2023-08-17 |