| NPI | 1942511597 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD450228) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT197625) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY P92696) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-06-29 |
| Last Update Date | 2014-06-17 |