| NPI | 1922236280 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: CA A114895) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A114895) | |
| Enumeration Date | 2009-06-25 |
| Last Update Date | 2021-11-17 |