| NPI | 1992219216 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 290773) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NM RS2017-1004) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA 290773) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NM MD2022-0007) | |
| Enumeration Date | 2017-11-22 |
| Last Update Date | 2022-07-08 |