| NPI | 1972180669 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: MD D0103604) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: DC MD600004323) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-03-27 |
| Last Update Date | 2025-08-11 |