NPI | 1376805317 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: NH 18377) |
Additional Taxonomies | 2080P0008X Pediatrics, Neurodevelopmental Disabilities (Licence: NH 18377) |
2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: ME MD26607) | |
2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: MA 1013260) | |
208D00000X General Practice (Licence: NH 18377) | |
Enumeration Date | 2012-06-14 |
Last Update Date | 2023-04-12 |