NPI | 1255727145 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: VA 0102206585) |
Additional Taxonomies | 208000000X Pediatrics (Licence: AL 2187) |
2080S0012X Pediatrics, Sleep Medicine (Licence: AL 2187) | |
2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: AL 2187) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2015-04-08 |
Last Update Date | 2024-03-28 |