| 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 |