NPI | 1124305297 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: OH 35.122215) |
Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35.122215) |
Enumeration Date | 2011-11-03 |
Last Update Date | 2017-02-06 |