NPI | 1881128320 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: KY C3947) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME151830) |
2084N0400X Psychiatry & Neurology, Neurology (Licence: OR MD226036) | |
2084N0400X Psychiatry & Neurology, Neurology (Licence: WA MD70001081) | |
390200000X Student in an Organized Health Care Education/Training Program (Licence: FL P620800883740) | |
Enumeration Date | 2017-04-11 |
Last Update Date | 2025-07-01 |