NPI | 1891321824 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME176135) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: KY 60463) |
390200000X Student in an Organized Health Care Education/Training Program | |
2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A79561) | |
Enumeration Date | 2020-03-21 |
Last Update Date | 2025-08-12 |