| NPI | 1326278342 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: KY TP268) |
| Additional Taxonomies | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: SC 33113) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301082663) | |
| Enumeration Date | 2009-07-24 |
| Last Update Date | 2021-01-26 |