| NPI | 1952807463 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX V6854) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: AR E-17746) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX V4874) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101275503) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-04-03 |
| Last Update Date | 2025-12-19 |