| NPI | 1942793237 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: WI 81927) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.072945) |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: IL 125.072945) | |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: IL 036161472) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-06-11 |
| Last Update Date | 2023-05-09 |