NPI | 1982109849 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: UT 13222513-1204) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: OH 34.014543) |
2084V0102X Psychiatry & Neurology Vascular Neurology (Licence: FL UO8129) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2018-03-24 |
Last Update Date | 2023-08-23 |