NPI | 1154338986 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: WA MD00027455) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WA MD00027455) |
208000000X Pediatrics (Licence: WA MD00027455) | |
2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: WA MD00027455) | |
Enumeration Date | 2006-08-02 |
Last Update Date | 2011-10-14 |