| NPI | 1992027809 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2084E0001X Psychiatry & Neurology, Epilepsy (Licence: MI 4301102378) | 
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 4301102378) | 
| 2084N0600X (Licence: MI 4301102378) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-02-18 | 
| Last Update Date | 2024-12-30 |