NPI | 1962845073 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A134843) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
2084N0400X Psychiatry & Neurology, Neurology (Licence: IL 036-158092) | |
Enumeration Date | 2013-04-09 |
Last Update Date | 2022-03-15 |