| NPI | 1942867825 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: IL 036.165909) |
| Enumeration Date | 2019-05-25 |
| Last Update Date | 2023-08-08 |