| NPI | 1144403171 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: TN 43697) |
| Additional Taxonomies | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: OH 2012-00446) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-12-13 |
| Last Update Date | 2022-11-29 |